|
<br />rJ~/,'::l,/'.2t~Ul 17:l.Ct
<br />
<br />'=':-J~~jd..:; ::li:;L1L
<br />
<br />._li,'.1 J...!'~:'l...lr<;-,j. -j._.c...
<br />
<br />r..r-a'.....t:.. <...,.1.... U.L
<br />
<br />AE~~____.~ER"T_IFI~l'T~ OF~I~BI~ITY INSURANCE
<br />
<br />PRODUCER
<br />
<br />JW Insurance $eNlces
<br />100 North State Road 7, # 106
<br />~ M<lrg8lo, FL 33063
<br />. __~;or.e '.9.?4)583-!~~ . __ _ Fax ~9.~4)5e~2~~____
<br />
<br />- DATE (MMlOOIVY\-',
<br />05/31/11 ~
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONl-Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE I
<br />HOL.DER. THIS CERTlFICATE DO~S NOT AMEND. EXTEND OR I
<br />ALTER THE COVERAGE AFFORDED BY mE POLICIES BELOW. '
<br />
<br />- i::.;'R:~:"- i::~~:'1~: ~tRAGE- --:-~-~-=-' .Ai". ~.l
<br />Jri;;~ER ~.: "progressi~e . ~-=~-=-~_. -t -~~=~
<br />, .
<br />,-INSI.!R~.!!C: _.__ .__--- ---._.~ ---..-- .)
<br />INSURER D: I'
<br />___" ___.'--' .,___...---..-.-r-. ,
<br />
<br />COVERAGE.~~q~----__-_l :~~~~: ~ - -- ---~---T ---I
<br />
<br />... --THE POLICIES OF INSURANCE LISTED HAVe'BEE-NiSsu'EO'TO THE IN'SURE-D N,;,MaO"AOOVE FORTHE POLICY -PERIOO iNDICATED. NOTWITHSTANDING - .---. --I
<br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFICA TE MAY BE ISSUED OR I
<br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE:D HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH I
<br />, POL.ICIES AGGREGATE LIMITS SHOWN MAY HAVE BEgN REDUCED BY PAID CLAIMS. '
<br />
<br />'f~I=::E~:':;i~"-~----=--.. POLIC~ N"';~ - !~:.:~~r ~~,":r,~; EACH-OC~RREN~;"~-H1 :o~,~J
<br />
<br />;i! COMMERCIAL GENERAL LIABILITY . NN 105017 ! 03101/11 03/01/12~, ~~~~J~~~~nce) -~T,,- , . ".- --J
<br />;~:.J CLAIMS MADE ~ OCCUR ! MEP EXP (Anyone porson) I 5,00.~J
<br />i(1 '-.' 'Pc.RSONAL&ADVi'NJURY J, 1'OOO'O~--';
<br />_._.._ '. .___ . GE~.~AAL AGG_REGATE ..~~.u)~OCX?!~OO
<br />; GEN'L AGGREGATE LIMIT APPLllffi PER:: ' PRODUCTS. COMP/OP AGG I 1,000,000
<br />
<br />:~U~~~~:I~~=~~ LOC' -------.-------- . ~~~:~::D~~:t~~:;~ . i"._ -1"OO1(jOO-:-OOOO' o'~':
<br />
<br />,'. 05887846 2 '.' 07/23/10 07/23/11 I "
<br />, , ~: ~~:~D AUTOS" ! ::~7;;~RY -----r-...-...
<br />
<br />II B ~ SCHEDULED AUTOS (Per per.lOfl) ,
<br />
<br />
<br />
<br />:__o:~~~:~uros_---~----u_---- f~~~::~:-~~:-l
<br />
<br />.~~=.~~: ANYAUTO ..____,,___ ...._._...... .._..___---1 ~~~~~;~r ~~~c 1_ _"'~.~
<br />
<br />EXCESSlUMBRELLALIABILJTY I-EACHOCCURR~~.._ I ..----1
<br />..1 i~ OCCUR L; C"',,"MACE [""REGAlE ---t==- ...--
<br />
<br />
<br />'-c wo.~.~ ~;''=:ON ;Hjj----- -~--~-,~~~~ - .:j
<br />I cup 0 . . WCSiATU. "OTH'~ .
<br />...... l- YERS'LI,ABILITY :.......-=-_.JO,RY LIMITS. .-:..:..:....fB. ---
<br />I ANY PROPRIETOR I PARTN~R I EXECUTIVE . E.l. EACH ACCIDENT
<br />. ~:~;~~~~ EXCLUDED? ' E.l. DISEAS'!i':E"AEMPLOYEE, ..--' -I
<br />i-~~E~~ P~9.Y1SI0NS bGlow. __._____. ._______ .________ n'___'--..-i..~~ OISEASE.:POLI~Y lIM!,~,,_~~~
<br />
<br />I.i.__ I' L
<br />
<br />DESCRIPTION OF OPERAT;O"S "DCA TIONS-' v,ti,e':.. ",,<<o.i6.. AOOED BY ENoCRiEoIE"" i 'PEC,^L PRovis'ON' --- - ... ... -- -.- !
<br />:Certificate holder is listed as a additional insured for General Liability Only.
<br />
<br />I
<br />
<br />INSURED
<br />
<br />Coastal Contracting & Development, Inc.
<br />807 N. Northlaka Drive
<br />Hollywood, FL 33019
<br />
<br />IA
<br />
<br />-1.....
<br />
<br />CERTIFICATE HOLDER
<br />
<br />.._._......CANCELLATION ,..__.~.J~_...w_-_. .---.. .--...
<br />
<br />-----SHOULD ~;'OF TH~ ABOVE DE~-;~O po~iciE8 ,810 CANC~lLEO eEfORE THE"II
<br />EXPIRATlON DATE THr::REOF, THE ISSUING INSURER W1U ENDeAVOR TO MAIl..
<br />FOR YOUR RE=:CORDS 30 DAYS WRITTEN NcrnCE TO THE Ct:RTIFICATE HOlDER NAMED TO
<br />XXXXXXXXXXXXXXXXXXXXXXXXXXXXxxxxxxx THE LEfT, BUT 1'A1I..URE TO DO SO SHALl. IMPOSE NO OBUGATION OR LIABILITY .
<br />
<br />C XXJOO()Q()(XXXXXXXXXXXXXXXXXXXXXXX, XX -~~:= ~:~~:~~:~:R~~~~__--__I
<br />
<br />ACORD 25 (2001108)QF- .-. . -.----- . ".---. - ...---- n___ '--@ACORD CORPORATIOI\j'1988 -
<br />
|